Minnesota Attorney General Keith Ellison Brings Charges In Large Medicaid Fraud Case

Minnesota Attorney General Keith Ellison has brought charges against three people accused in a scheme to defraud the state's Medical Assistance program out of nearly $11 million.

It's the largest-ever fraud prosecution charged by a special state unit designated for these investigations within the state-federal Medicaid program, which provides health insurance to lower-income people.

Abdirashid Ismail Said, 48, of Fridley was charged this week in Hennepin County District Court with one count of racketeering, eight counts of aiding and abetting theft by swindle (more than $35,000) and one count of perjury for defrauding the Medicaid program through three home health care agencies he operated.

Two co-conspirators also were charged, according to a news release from Ellison's office. It noted that defendants are presumed innocent until proven guilty.

"Minnesotans who receive Medical Assistance have a right to expect that they'll receive all the care, dignity and respect they're entitled to," the attorney general said in a statement. "Minnesotans trying to afford their lives have a right to expect that every one of their tax dollars will be put to use properly. People who commit Medicaid fraud violate both of those rights."

A spokesman for Ellison said Said was in custody Friday morning at the Hennepin County Jail in advance of an afternoon court hearing.

The Minnesota Medicaid Fraud Control Unit (MFCU) has previously charged and prosecuted Said, according to the attorney general's office. In 2022, he was convicted of Medicaid fraud, ordered to repay the state $77,000 and barred from working with any Medicaid-funded agency.

After the conviction, other agencies that Said operated billed the Medicaid program for providing both home- and community-based waivered services and personal care assistant (PCA) services, the attorney general alleges.

The attorney general asserts the home health care agencies "routinely billed for services not provided at all, for more services than documented in employee timesheets, for PCA services that were not supervised by a qualified professional (as required by Minnesota law)," according to a news release.

"Often, these findings resulted from workers or clients who said they did not receive any services from the agencies, despite the agencies billing for services provided to them," the news release said. "MFCU investigators found that, between all of the agencies, Said and his co-conspirators billed $997,000 for recipients who denied receiving services, overbilled for over $300,000 and billed over $5.8 million for services that were not documented or were fraudulently documented."

Four other people were previously charged as part of the investigation. Additional charges are expected against other individuals, the attorney general said, including owners and employees of other agencies.

The case was jointly investigated by the Medicaid Fraud Control Unit within Ellison's office and the U.S. Department of Health and Human Services' Office of Inspector General (HHS-OIG).

"Individuals who seek illicit gains from Medicaid do so to the detriment of those beneficiaries who rely on the continued solvency and integrity of these vital federal health care programs," said Mario M. Pinto, the special agent in charge of HHS-OIG, in a statement. "Our agency is committed to working together with our state law enforcement partners to ensure that those who engage in fraud are held accountable."

SOURCE: Star Tribune